| NPI | 1093443533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY HALANSKI Md 877-644-6008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2022-08-11 |
| Last Update Date | 2023-06-15 |